S.NO SPECIFIC TIME CONTENT TEACHERS LEARNERS AV.

AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY

01. To introduce 3 Min INTRODUCTION: Lecture cum Listening Black board What is meaning
self and topic I am jatinder kaur, student of M.Sc 1st year. My topic is discussion of the topic?
Congestive heart failure. It is a condition in which the
heart can no longer sufficiently supply the body with
the blood needed to maintain homeostasis. This
compensation begins with a decrease in systemic blood
flow as a result of increased peripheral resistance in the
pulmonary system.

02. Define CHF 3 Min DEFINITION: Lecture cum Listening Black board What is the
CHF is a term defined as inability of the heart to pump discussion definition of
enough blood out to the rest of the body, at rest or CHF?
during stress,and inability to receive blood into the
ventricular cavities at low pressure during diastolic
pressure.

03. Explain the 5 Min ETIOLOGY: Lecture cum Listening Flash cards What is the
etiology  Enlargement of thre heart. discussion etiology of
 Heart valve disease. CHF?
 Cardiac arrhythmias(irregular heartbeats)
 Chronic lung disease.
 Anemia (uncomman in children).
 Viral infections.
 Hypertension.
 Hemorrhage.
 Unknown.
S.NO SPECIFIC TIME CONTENT TEACHERS LEARNERS AV. AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY

04. Describe the 5 Min PATHOPHYSIOLOGY: Lecture cum Listening Black board What is the
Patho- discussion pathophysiology
physiology Of of CHF?
CHF.

Heart demage ventricular overload

Decreased ventricular contraction

Tachycardia ventri- fluid overloaded

cular dilation myoc- edema
ardial hypertrophy

Decreased cardiac Increased water

output reabsorption

Decreased renal Increased ADH

perfusion

Increased sodium Increase osmotic

retention pressure
S.NO SPECIFIC TIME CONTENT TEACHERS LEARNERS AV. AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY

05. Enlist the sign 5 Min SIGN AND SYMPTOMS: Lecture cum Listening Flash cards What are the sign
and symptoms The following are the most common symptoms of discussion and symptoms of
of CHF. heart failure.However each child may experience CHF?
symptoms differently. Symptoms may inculde:
 Visible swelling of the legs, ankles, eyelids,
face.
 Abnormal fast breathing.
 Shortness of breath.
 Fatigue.
 Nauses.
 Falling asleep when feeding or becoming too
tired to eat.
 Lack of appetite.
 Weight gain over a short period of time even
when the appetite is poor, typically due to fluid
retention.
 Cough and congestion in the lungs.
 Sewating while feeding, playing, or exercising.
 Breathing difficulty with acitivity, especially
while feeding, walking or climbing stairs.
 Loss of muscle mass.
 Change in skin temperature and colour

06. Explain the 5 Min DIAGNOSIS: Lecture cum Listening Black board What are the
diagnosis of discussion diagnosis
CHF.  PHYSICAL EXAMINATION: A Child with of CHF?
CCF may present tachycardia, tachypnea,
gallop rhythm, dyspnea, decreased peripheral
pulse and mottling of the extremities, delayed
caplliary refill, failure to thrive, decreased
activity tolerance, sweating,etc.
 CHEST X-RAY: Very common x-ray shows
cardio- both in presence of volume and
pressure overload or dysrhythmias.
S.NO SPECIFIC TIME CONTENT TEACHERS LEARNERS AV. AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY

 ECG: Usually abnormal and although not

useful in HF, may give diagnostic clues for the
underlying pathology of heart failure .
 URINE ROUTINE: In chronic HF
proteinuria and high specific gravity of urine
are common.
 BLOOD TEST: Atrial blood gas analysis is
important.
Other tests are:
-Complete hemogram
-Serum electrolytes
-Liver function tests
-Serology
-Renal function test
 ECHOCARDIOGRAM: The test is very
important for evaluating cardiac function and
ruling out structural heart diseases.
07. Elaborate the 5 Min MEDICAL MANAGEMENT: Lecture cum Listening Black board What is the Medical
Medical discussion Management of
 Remove accumulated fluid and sodium with
Management of CHF?
the help of medicine.
CHF.
 Diuretices ( frusomide /kg of body weight )of
the child.
 Administration of morphine sulphate
(0.05mg/kg) or other sedatives (Diazepam)
may be needed if the child is restless.
 Administration the antibiotics to prevent
hospital aquired infection.
S.NO SPECIFIC TIME CONTENT TEACHERS LEARNERS AV. AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY
 Antipyrictics drugs given in case of
hyperthermiea.
 I/V (intravenous) fluid strictly restricted.
 Antiarrhythmic drugs(Aminodarone)/mg/kg to
regular heart beats.
 Oxygen should be provided if dyspnea occure.
08. Clarify Nursing 7min NURSING MANAGEMENT: Lecture cum Listening Black board What is the Nursing
Management of It’s wriiten under followings with help of diagonosis: discussion Management of
CHF. 1). Impaired gass exchage related to altered pulmonary CHF?
blood flow/ oxygen deprivation.
2). Fluid volume excess related to fluid accumulation .
3). Activity intolerance related to decreased cardiac
output due to myocardial dysfunction.

EXPLAIN THE DIAGNOSIS WITH GOAL AND

NURSING INTERVENTIONS:

DIAGNOSIS:-1
Impaired gass exchange related to altered to
pulmonary blood flow/oxygen deprivations.
GOAL: To maintain the respiratory function.
INTERVENTIONS:
* Placing the child in inclined postion of 30 to 45
degree.
* Administer humidified O2 as prescribed.
* Avoid any constricting clothing or restraints around
abdomen and chest.
* Use bipap support to provide high density of oxygen
as prescribed by the physcian.

DIAGNOSIS:-2
Fluid volume excess related to fluid accumulation.
GOAL: To remove the excessive fluid.
S.NO SPECIFIC TIME CONTENT TEACHERS LEARNERS AV. AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY

INTERVENTIONS:
* Adiminster Diuretics as prescribed by the doctor.
* Check to reduce the edema or not and inform the
doctor and record as well.
* Provide skin care for children with edema.
* Use air matress to prevent form bed sores.
* Strictly measurement of urine out and intake of the
child.
* Handling the child with aseptic technique to prevent
further complications like: fever.

DIAGNOSIS:-3
Activity intolerance related to decreased cardiac output
due to myocardial dysfunction.
GOAL: To exhibit improved cardiac output.
INTERVENTIONS:
* Administer of Digoxin at regular interval (usually
every 12 hours).
* Take an ECG to check cardiac status after administ-
ration of medicine.
* Monitor the electrolyte level every 24 hours to
maintain normal value.
* Check the blood pressure to obseve for signs of hypo-
tension.because digoxin may cause of hypotension.
* Maintenance of nutrition and hydration of client.

09. To summarize 5 Min SUMMARIZATION:

the topic. Today we have discussed:
* Definition of CHF.
* Etilogy of CHF.
* Pathophysiology of CHF.
* Sign and symptoms of CHF.
* Diagnosis of CHF.
* Medical management of CHF.
* Nursing management of CHF.
S.NO SPECIFIC TIME CONTENT TEACHERS LEARNERS AV. AIDS EVALUATION
OBJECTIVE ACTIVITY ACTIVITY

10. Recapitalize 4 Min RECAPITALIZATION :

the topic. * What is definition of CHF?
* What is the etiology of CHF?
* What is pathophysiology of CHF?
* What are the sign and symptoms of CHF?
* What are the diagnosis of CHF?
* What is the medical management of CHF?
* What is the Nursing management of CHF?

BIBLIOGRAPHY
1). Sarkar subrata, Pediatric Nursing, 1st Edition 2018,
Jaypee Brothers Medical Publication (P) Ltd, New
Delhi, Page No. 485-489.
2). Datta parul, Pediatric Nursing, 2nd Edition 2009,
Jaypee Brothers Medical Publication (P) Ltd, New
Delhi, Page No. 215-220.
3). Wong’s, Essential Of Pediatric Nursing, 8th Edition
2009, Elsevier, First Floor, Noida, (UP), Page No.
200-205.